How important is POA for Health and Welfare?

[Lightbeam]

My aunt is 86 and getting increasingly frail and forgetful. Years ago (2007) she made an Enduring POA which covers Finance, my sister and I are listed as her attorneys on this. It is not registered yet, (enduring POA is only registered once they start to lose capacity).
But we don't have Health and Welfare POA. How important is it we get one? Or can we just rely on NOK status? It'll be quite a bit of an effort to get one for her as she is house-bound, reclusive and seemingly no able bodied friends to witness etc.

My sister and I are her only relatives.

Sister and I live about 90 minutes away, both with full time jobs and young children. Neither of us are in a position to provide any care for her outside of admin type stuff, in case that matters.

I personally feel it doesn't make that much difference, but perhaps I just deliberately feel that so I don't feel so upset that my mum wouldn't grant one! She has no mental capacity now and is at the mercy of the consultants. She went into a hospital recently and they barely talked to us and made decisions we disagreed with.

It has to be said that LPA doesn't make such a difference as it should, and neither does a living will. LPA should legally mean that they talk to you about medical decisions as if you were the person involved. I've seen that principle ignored and people being treated with things they had specifically refused in writing in advance. It's also quite a burden, or should be.

My view would be that if your aunt has strong views about refusing treatment or types of treatment, LPA is important. If she has few strong views about this and generally trusts doctors, it may not be worth the hassle.

POA for health and welfare is hugely important where an individual lacks capacity to make decisions on these issues for themselves - and that will be most people towards the end of their lives.
If the family do not have this the Local Authority will step in and assume it. I know of one case where they sent an elderly person to a truly dire care home. Family believed that this was not in the best interests of the individual and that the LA had chosen that home as their relative was a self funder and they wanted more self funders in there to subsidise the LA inmates. Very difficult to fight their decision without spending a lot of money on legal representation.

It's not as important as the financial POA. If you have good open communication with the consultants you can guide them within reason without a Health POA. Important to have a Do Not Resuscitate statement to hand if that is their wish.

I don’t know what it would be like if I didn’t have POA but my father’s nursing home takes seriously both the POA and the Letter of Wishes he attached to it.

I wonder whether being her niece would mean having POA is more important than if you were her daughter

Thank you so much for your responses.
She has enough assets to be fully self funded even if she spent several years in a care home. So I had assumed that self funders can pick care homes. If/when it came to that it would make sense for her to move to a home near my sister or I.

Although when talking through her future wishes re care, the only opinion she has ever expressed is she doesn't want to go into a home, like ever.

Yes possibly.
Rather selfishly I'm dreading getting more involved. I already have a DF with dementia for whom I'm attorney. And I'm the executor for my recently deceased DM's estate (Aunt's sister).

I do care for my Aunt, but I don't want to care for her. If that makes sense.

I had financial POA for my Mum but not health. It didn't seem to matter, I was never asked for it and when doctors realised her capacity was poor (dementia) they would speak with me.

I don't think it is something you would ever regret having but you might regret not having it.

When my mum was in hospital last year i was asked if we had POA for health and they were pleased that we did. I suppose it makes things easier.

It definitely means more involvement. Tbh I wouldn't push for it. Try not to worry- nobody could possibly blame you for not pushing her to have one, most people don't.

If you want to, encourage her to write her views down. My experience is that this generation expect their views to be understood by telepathy tbh, or even better by nobody ever discussing it. As a result I have everything written down and signed/witnessed/dated in my GP record and am still pessimistic about it being implemented.

Ditto what @SoupDragon says.
If you need it and have left it too late it will be a massive ball ache.

I have both for my FIL and it just makes all interactions with health and financial professionals easier.

He was very accepting to getting in place which of course helps.

We didn’t have it. DM was sectioned my DF died unexpectedly. My DM couldn’t be transferred out the Mental Heath Unit she found herself in as it was the address given for her while court papers were lodged to get Guardianship. Nightmare. Always worth getting.

It depends how much "fight" you might want. If, like I did, you'd follow the doctors' advice anyway, it doesn't matter.

Thank you all. I think I might as well try gently to get it in place, as you say, it may make a difference, we won’t know until the time comes.

My aunt was apathetic rather than resistant when I tried to discuss it recently.

I think she might be more receptive if my husband talks to her, she’s definitely a women of that generation who has greater respect for a man’s opinion.

My MIL refused everything, was deemed to have capacity, yet needed to go in a home. We went through SS and the courts to do that, and access her account, as things needed paying.
It can be done without.

But it is far easier to do it with.

If she had capacity POA wouldn't have helped?

It made a huge difference for us when DF was dying and his GP seemed happy to leave him to it at home in agony.

They absolutely wouldn't speak to us until we produced it. Once we did and I got to speak to a GP and talk through how it was absolutely fucking unacceptable their treatment so far and the future plans for him we were able to get him proper pain relief, a Hospital Bed, Hospice at a Home and a place in the local Hospice at the end, which was his wish.

Im making the point that things can be achieved without it,

And as I wrote at the beginning, she refused everything, so it wasn’t easier.

You didn't have it so you wouldn't know.

An older friend was very distressed when her old, frail husband was given CPR when in all likelihood he had passed away a good while earlier that day. The paramedics apparently said that if she'd had health LPA she could have prevented that. From what I remember of sorting out my own LPA I think there's some truth to that, although that reminds me I should probably sort out a proper Advance Directive as well!

I found it was a useful bit of paper to wave to get the medics to talk to me, even though Mum had capacity more often than not (infections and low SATS sometimes made her either a bit out of it or completely away with the fairies).

NOK is not legally binding. Everyone should have LPOA in place for health and welfare, and property and finance regardless of age or illness as you just don't know what can happen at any time. Living will/advanced care plans should also be in place. It's 80 something £ to apply for LPOA through the gov website.